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- Title
Type 2 Diabetes and Higher Hip Fracture Risk in Older White and Black Men and Women: The Cardiovascular Health Study.
- Authors
Strotmeyer, Elsa S.; Kamineni, Aruna; Cauley, Jane A.; Robbins, John A.; Fried, Linda F.; Siscovick, David S.; Harris, Tamara B.; Newman, Anne B.
- Abstract
Older white women with type 2 diabetes (DM) may have higher fracture rates despite higher weight and bone mineral density, though little information exists for men, blacks or those with impaired fasting glucose (IFG). The Cardiovascular Health Study (CHS) included 5888 white and black men and women, followed 10.1±3.9 years for health events including incident hip fractures (ICD-9 codes 820.xx). Participants with hip fracture concurrent to motor vehicle accidents (N=9, ICD-9 E810-E825) or pathologic fracture (N=8, ICD-9 733.1) or missing fasting glucose (FG; N=358) were excluded. In 5513 participants, 419 hip fractures occurred. DM was defined as hypoglycemic medication use or FG ≥126 mg/dl and IFG was defined as FG ≥ 100 and < 126 mg/dl. Of participants (mean age 72.8±5.6 years; 42.4% men; 16% black), 17% had DM and 39% had IFG at baseline. Participants with DM or IFG were more likely men (49% and 46% vs. 36%; p<0.001) and those with DM were more likely black (24% vs. 16%; p<0.001) than those with normal FG. Crude hip fracture rates (/1000 person-years) were 8.5 (95%CI: 7.4-9.6) for normal FG, 6.6 (95%CI: 5.6-7.7) for IFG, and 7.3 (95%CI: 5.7-9.5) for DM. In Cox regression models adjusted for gender, race, age, body mass index (BMI), DM was significantly related to hip fractures (HR=l.37; 95%CI: 1.01-1.85). IFG was not related to hip fracture (HR=0.92; 95%CI: 0.74-1.14). There were no interactions of race or gender with DM or IFG and women and men had similar HR. Clinical cardiovascular disease, creatinine ≥1.5 mg/dl in men and ≥1.3 mg/dl in women, and vision problems did not attenuate the HR. However, ankle-arm index <0.9 reduced the HR for DM [1.28 (0.94-1.75)] and was marginally related to hip fracture [1.31 (0.99-1.72)]. DM was independently associated with 37% higher hip fracture risk after adjusting for higher BMI in diabetic participants. Older diabetic adults, possibly those with subclinical peripheral vascular disease, may need to be targeted for tincture prevention. ADA-Funded Research
- Subjects
TYPE 2 diabetes; DIABETES in women; DIABETES in old age; BONE fractures in old age; GLUCOSE; DIABETES; CREATININE
- Publication
Diabetes, 2007, Vol 56, pA259
- ISSN
0012-1797
- Publication type
Article